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Psychopharmacology > Opioids > Flashcards

Opioids Flashcards

1
Q

What is the typical pattern of intake of an opioid-dependent person compared to a high-efficacy stimulant dependent person?

A

Opiate dependent is more consistent than the binge-crash cycle of stimulant-dependent bc opiate withdrawals are so awful that they just continuously take the drug when they start to feel the high wearing off

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2
Q

3 endogenous opioids

A

Enkephalins, endorphins and dynorphins

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3
Q

What drug mixture gained recognition in the 1800s as a widespread use medical remedy?

A

Laudanum: opium + ethanol

used for teething drops for babies

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4
Q

What is the term used for the places people would go to smoke opium in the late 1800-early 1900s in America?

A

Opium dens

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5
Q

What tool was invented in 1853 that caused a spike in opioid use?

A

Hypodermic needle

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6
Q

What is the Harrison Act and what year was it enacted?

A

The ban of non-medical use of opioids; 1914

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7
Q

When was heroin deemed illegal?

A

1924

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8
Q

What opioid is the latest threat to OD deaths?

A

Fentanyl

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9
Q

Common routes of admin for opioids

A
  • oral (pills, tinctures, lollipops)
  • IV (heroin)
  • inhalation
  • intranasal (sprays)
  • intramuscular
  • transdermal (patches)
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10
Q

Where is the psychoactive substance in the opium poppy found?

A

White sap in the seed pod

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11
Q

Opioid effects and their brain regions

A

analgesia: SC and PAG
euphoria: VTA
respiratory depression: medulla
hypothermia: hypothalamus
catatonia: cerebellum
dream like state: frontal cortex
constipation
anti cough/nausea: medulla
itching due to histamine release
PINPOINT pupils

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12
Q

Which effects are lacking the most when opioid users first become tolerant?

A

Analgesia and euphoria

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13
Q

Which effects disappear the slowest in opioid tolerant users?

A

Constipation and respiratory depression

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14
Q

Which effect will never disappear no matter how tolerant an opioid user is?

A

Pinpoint pupils

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15
Q

Withdrawal symptoms of opioids (8)

A 
Hyperalgesia
Dysphoria
Increased respiration
Light sensitivity
Violent yawning
Spontaneous ejaculation
Restlessness
Flu like symptoms
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16
Q

Is there cross tolerance among all opioids?

A

Yes

17
Q

Psychophysiological effects of opioids and their areas (3)

A

Shallow breathing, tiredness, pain relief (brainstem)
Fight or flight suppression: LC
Euphoria: mesolimbic pathway

18
Q

How long after the last dose do withdrawal symptoms appear? How long can they last?

A

Appear 6-12hrs after last dose; can last 7-10 days with a peak at 2-3 days

19
Q

Why is opioid addiction so heavily maintained?

A

Users change form chasing the high to avoiding withdrawals

20
Q

Triad of symptoms of opioid overdose

A
  1. Coma
  2. Pinpoint pupils
  3. Respiratory depression
21
Q

Primary medical attention for an opioid OD

A

Ventilation and opioid antagonist (Narcan)

22
Q

What is antagonist precipitated withdrawal?

A

Using an opioid antagonist on someone who’s OD’d can create immediate withdrawal effects

23
Q

When would someone find clonidine helpful?

A

When trying to gradually terminate their use of opioids in hopes of avoiding withdrawals
It’s an NE agonist so it suppresses nausea, diarrhea, cramping and sweating

24
Q

What is replacement therapy?

A

Replacing the use of an opioid with a “less harmful” one like methadone and buprenorphine

25
Q

Points about buprenorphine

A

Mild withdrawals
Low abuse potential
Blocks high efficacy agonists
Wide margin of safety

26
Q

Benefits of replacement drugs

A 
Oral
Long duration of action
Low cost
Milder withdrawals
Blocks effects of higher efficacy opioids
27
Q

What is blockade therapy and what are some drugs used?

A

Blocks all of an agonists effects.

Naloxone (Narcan) or Naltrexone

28
Q

What is suboxone?

A

Part buprenorphine part naloxone: when crushed up and used IV a user goes straight into precipitated withdrawal
CURRENT REPLACEMENT THERAPY APPROACH

29
Q

2 opium derived agonists

A

Morphine and codeine

30
Q

Opium and alcohol tincture

A

Laudanum

31
Q

2 main synthetic opioid agonists

A

Heroin and fentanyl

32
Q

What stands out about the half lifes of opioids?

A

Varies with route of admin

33
Q

Which opioid drug has the longest half life?

A

Buprenorphine, 27hrs buccal route (cheek)

34
Q

Which enzyme breaks heroin down into morphine?

A

CYP enzymes

35
Q

Primary opioid recpetor

A

Mu receptor

36
Q

What effects did the opioid rat show?

A 
Barely moving after 5 mins
Not much muscle tone loss
No loss of coordination
Showed max analgesic response
Showed quick pain response when treated with an antagonist

Psychopharmacology (11 decks)

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